Notes from the Trenches: Quick Teletherapy

Many behavioral health organizations, including my own clients, are putting together heroic efforts to transition operations online so that services to patients may continue. High-anxiety due to isolation and quarantine only increases the demand for psychotherapy, and therefore the need for providers to quickly find an answer.

Below are a few practical words of advice. This is not a marketing teaser, if you need my help I will offer it free of charge.

Service Offering: Not all of your services may transition easily to teletherapy. While behavioral providers rely less on physical examinations, some high-risk cases may not be a good fit.

1. Consult with your clinician leadership to map out which services you choose to transition.

2. Create protocols and guidelines for each service identified.

3. Provide training through recorded sessions or "cheat sheets".

Operations: As you transition to teletherapy, patient interaction will become remote for your administrative staff as well. That spells a few changes to workflows:

1. Registration: More than ever, it is important to have means of payment on file (such as a credit card). Make it a requirement.

2. Check-in: Physical check-in is no longer possible. Instead, have your staff review the lists of coming-up patients (48 hours in advance) and contact patients whose information is lacking. You may also collect co-pays that way in cases where a credit card on file is missing.

3. Scheduling: Note that if your teletherapy tool is not embedded within your EHR, it will be required to maintain your schedule across two platforms. In addition, if the solution is not embedded, you will need to develop a workflow where appointment notification and links are sent to the patient.

Technology: The key piece is to quickly identify a teletherapy solution while also verifying that your hardware can handle the increased traffic (if you use a product such as VPN).

1. Teletherapy Solution: You will quickly find that you are facing two major alternatives. Your EHR's embedded solution or an independent platform. If your EHR has an embedded solution, find out the price but also make sure that your network can handle the increased traffic (if access to your EHR is enabled through VPN or a similar solution). If you choose to go with an independent platform, make sure it is compatible with regulatory requirements (the requirements have been relaxed recently), and remember, you will most likely have to handle two schedules: The EHR's and the standalone platform. Most independent platforms can be quickly contracted with and scaled up.

2. Hardware: As alluded before, teletherapy may come with an increased demand on your network. Make sure your network can handle it, or use a solution secure enough that requires no VPN access.

3. Administrative Staff: In addition, you may choose to let your administrative staff work remotely as well - make sure they have home computers and make sure (and test) that they can access from home the applications required for their work.

While implementing a teletherapy solution prior to planning a detailed teletherapy strategy may sound counterintuitive (horses and carts in the wrong order), it may actually benefit your organization down the road. By the time the dust settles, you will have accumulated great organizational experience in matters of what works and what does not work for your practitioners, staff and patients. As Salisbury said, "a gram of experience is worth a ton of theory!" 

contact: rmoran@arrowwoodhc.com